Immune-based therapies—including immune checkpoint inhibitors (ICIs), bispecific T cell engagers (BiTEs), chimeric antigen receptor (CAR) T cells, and tumor-infiltrating lymphocytes (TILs)—have transformed cancer treatment but also introduced significant cardiovascular complications, posing new challenges for cardio-oncology. Growing recognition of cardiovascular immune-related adverse events has spurred research into the immune–cardiovascular interface, particularly dysregulated signaling, T cell overactivation, and cytokine release. This review synthesizes recent insights into the role of immune checkpoints in cardiovascular disease, the mechanisms of ICI- and T cell–induced cardiotoxicity, and the therapeutic potential of immune checkpoint modulation and CAR T cell therapy in cardiovascular applications.
JACC CardioOncology Editor-in-Chief and CME Editor
Bonnie Ky, MD, MSCE, FACC
Author
Sophie Van Linthout, PhD
Important Dates
Date of Release: August 19, 2025
Term of Approval/Date of CME/MOC Expiration: August 18, 2026